Pneumococcemia in children – a retrospective study before universal pneumococcal vaccinations. (28th February 2013)

• Record Type: Journal Article
• Authors: Karppa, Henna; Vuento, Risto; Toropainen, Maija; Kaijalainen, Tarja; Siira, Lotta; Korppi, Matti
• Is Part Of: Acta pædiatrica. Volume 102:Number 5(2013:May)
• Page Start: 514
• Page End: 519
• Publication Date: 2013-02-28
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12194
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" id="apa12194-abs-0001"> <title>Abstract</title> <sec id="apa12194-sec-0001" sec-type="section"> <title>Aim</title> <p>To evaluate the incidence and characteristics of blood culture‐positive occult pneumococcemia compared with blood culture‐positive pneumococcal pneumonia in children.</p> </sec> <sec id="apa12194-sec-0002" sec-type="section"> <title>Methods</title> <p>In years 2001–2010, 105 children with positive blood cultures for <italic>Streptococcus pneumoniae</italic> were identified from hospital electronic files. The patient cards were retrospectively charted for clinical and laboratory data, and 38 patients had and 67 had not pneumonia.</p> </sec> <sec id="apa12194-sec-0003" sec-type="section"> <title>Results</title> <p>The annual incidence of pneumococcemia was, on average, 29.0/10 000 at 0–12 months, 5.3/10 000 at 13–24 months and 1.9/10 000 at 2–4 years of ages, with no increasing or decreasing trend. The incidence of bacteraemic pneumococcal pneumonia increased (p = 0.022) during the study period. The duration of fever before hospitalization (<24 h 73.9% vs. 25.0%, p = 0.022) and the duration of intravenous antibiotics, usually G‐penicillin (median 72 vs. 96 h, p = 0.021) was shorter in pneumococcemia patients. On admission, blood leucocyte count was higher in pneumococcemia (mean 26.6 vs. 21.9 × 10E9/L, p = 0.012), but serum CRP was higher in pneumonia (median 160 vs. 67.4 mg/L, p < 0.001). The serotypes 6B and 14 caused 53.2% of pneumococcemia cases.</p> </sec> <sec id="apa12194-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The incidence of pneumococcemia was highest in 1–2‐year‐old children, and typical for pneumococcemia was rapid onset of fever, high blood leucocyte count and a modestly elevated CRP on admission.</p> </sec> </abstract>